Purpose: The purpose of this study is investigation of clinical and functional outcomes in homogeneous group with positive culture after arthroscopic management for pyogenic knee arthritis and analysis of factors affecting those outcomes. Materials and Methods: Thirty-two patients with positive culture after arthroscopic management were included. Mean follow-up period was 41.6 months. Clinical evaluation included death related to infection, recurrence, time to normalize erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), duration of administration of intravenous antibiotics and readmission. Radiographic evaluation was performed according to Kellgren and Lawrence. The prevalence of total knee arthroplasty was investigated and functional evaluation included modified Lysholm, Tegner activity and Korean version of the Western Ontario and McMaster Universities (K-WOMAC) score. Results: Staphylococcus aureus was identified in 21 patients. Time to normalize ESR and CRP was 78.0 and 67.6 days, respectively. Two patients died while there were six recurrences and five readmissions. Rate of recurrence was significantly high in patients with chronic renal failure (P=0.034) and incidence of readmission was associated with higher radiographic grade of osteoarthritis and rate of reoperation (P=0.032 and P=0.006, respectively). At the final follow-up, radiographic grade worsened in 21 patients and was associated with those at first visit. Five arthroplasties were performed. Average modified Lysholm score, Tegner activity score and K-WOMAC score were 53.5, 2.7, 44.2 points, respectively. Conclusion: The severity of osteoarthritis on final radiographs was associated with those at first visit. Patients with higher grade of osteoarthritis at first visit showed higher incidence of readmission and those with chronic renal failure demonstrated higher chances of recurrence.
The Journal of Korean Academic Society of Nursing Education
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v.9
no.2
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pp.253-263
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2003
Rheumatoid arthritis patients not only suffer from the physical damage, but they are afflicted severely mental and psychologic after effects. Their depression and low self-esteem eventually yields serious mental damages, which makes difficult for them to recover. The states of mental health of arthritis patients are diversified depending on the characters and surrounding circumstances, although they may have suffered from the similar condition. Therefore this research was conbucted to the factors that can give positive influences to the patients. In recent time, social support for the arthritis patients has become an important factor that can positively influence their mental health. In other words, social support can act as an important environmental system for arthritis patients to recover their damaged mental health. In order to fulfill this purpose, 118 patients were examined to identify the relationship between the variables. The summary of the result obtained from the research is as follow: 1. The structural aspect of social support for arthritis patients showed the most of them had various social support network size and their highest support system were 'family', 'relative' and 'friends'. The functional aspect of social support for arthritis patients showed moderate degree and their highest sub component was 'approval'. 2. High correlation was found between duration of relationship, similarity, frequency of meeting and functional support. There was no relationship between depression, self-esteem and social support. 3. Therefore this research has suggested that nurses who care rheumatoid arthritis patient consider the above condition to develop self-help group.
Journal of Korean Academy of Fundamentals of Nursing
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v.15
no.3
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pp.350-359
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2008
Purpose: The purpose of this study was to identify change in the exercise behavior and to identify factors influencing long-term adherence to aquatic exercise in patients with arthritis as a follow-up study after five years. Method: Baseline data had been collected using a structured interview 6 months after participants completed the aquatic exercise educational program. This second follow-up data collection included 133 participants from the original baseline study and was done 5 years after the original baseline study. Data was analyzed using SPSS 16 Win program. Results: The stage of change for the participants was as follows: Precontemplation (44.3%), Contemplation (24.1%), Preparation (3.0%), Action (0%) and Maintenance (adherence, 28.6%). The adherers (N=38) had significantly higher scores than non-adherers (N=91) in self-efficacy, outcome expectancy, group coherence and self-evaluation, and significantly lower scores in barriers to exercise. In logistic regression analysis, self-efficacy, group cohesion, barriers to exercise and self-evaluation were associated with exercise adherence (Chi Square=17.14, p=.002). Group cohesion (OR=2.5871, 95% CI=1.094-6.113, p= .030) was the most important factor. Conclusion: Self-efficacy, group cohesion, barriers to exercise and self-evaluation need to be considered in planning exercise programs to improve exercise adherence.
The purpose of this study was to identify the relationship between self-efficacy and adherence of aquatic exercise in patients with chronic arthritis. Subjects were 54 patients with rheumatoid arthritis and osteoarthritis who had participated in the 6-week aquatic exercise program. The results indicated that the relationship between self-efficacy and aquatic exercise adherence in patients with chronic arthritis was statistically significant. A significant difference of self-efficacy was found between adherers and non-adherers and self-efficacy of adherer was higher than that of non-adherer(t=5.21, p=.000). Self-efficacy was significantly associated with the total duration of an aquatic exercise adherence(r=.44, p=.001). Based on these results, self-efficacy was the important factor which affect adherence of aquatic exercise in patients with chronic arthritis. Further study was suggested to identify the relationships among self-efficacy, exercise barrier and other possible factors.
The purpose of this study was to identify functional impairment and psychological status and to analyze their relationships in patients with chronic arthritis. The sample was consisted of 75 arthritic patients who visited H hospital and S welfare center. Functional impairment was measured by ADL, pain, and the number of painful joint. Psychological status was measured by depression, self-efficacy, and quality of life. Data was analyzed by frequency, mean ${\pm} SD$, Pearson's correlation coefficient, and Stepwise multiple regression. The results of this study were as follows : 1. In functional Impairment, ADL was below average which means somewhat difficult, pain was above average, and the number of painful joint was 9.20. 2. In psychological status, scores of quality of life was 97.89, depression was 41.28, self-efficacy was 895.35. 3. Pain was negatively correlated to self-efficacy, ADL and quality of life, and positively correlated to depression. 4. Self efficacy and depression explained 45% of the variance in quality of life. Therefore, it is suggested that nursing intervention improving psychological status would be useful for patients with chronic arthritis. Especially, it is very important to implement nursing intervention focused on increasing self-efficacy and decreasing depression.
Purpose: To investigate the healing effect of 21 patients with chronic back pain, shoulder pain, and knee arthritis by a Qigong. Methods: The study performed by hand injection of a Soojung Qi-therapy. Results: Ten patients (47.6%) had low back pain, eight (38%) had frozen shoulders, and three (14.3%) had knee arthritis. Satisfaction after five times of the Qi-healing was 72% in those who returned to normal and 14% in those who improved. When the maximum pain level set at 5.0, the difference between before and after healing was 3.33 in arthritis subjects, 3.75 in fifty shoulder subjects, and 3.80 in low back pain. In general, the degree of pain decreased as the number of healings increased. In particular, even after the first healing, the pain reduction of the subjects was high in arthritis, frozen shoulders, and low back pain. That is, there was a possibility of controlling pain with only one Qi-healing. Conclusions: Soojung Qi-therapy is one of the natural healing treatments because it reduces fast pains and accessible to handling anytime and anywhere. Conclusions: With Qi-therapy, arthritis, frozen shoulder, and lumbago patients almost recovered to their original shape. Therefore, Qi-therapy regarded as one of the useful natural healing therapies.
Rheumatoid arthritis (RA) is a chronic inflammatory disease, which is mainly characterized by disease of joints affected with synovial hyperplasia, pathological immune response, and progressive destruction; all of which represent an important social health problem. These provide new insights in its pathogenesis of rheumatoid arthritis diagnosis and disease progression in molecular changes. This review focuses on new serological and immunological markers which seem to be useful in early diagnosis and prognosis of rheumatoid arthritis. Therefore, such tests are widely conducted for serological biomarkers and the developments with such immunological factors to identify patients who are at risk for disease progression. This evidence of the disease based on laboratory medicine could provide the best outcome for patients. Finally, data from recent studies will help to refine the ultimate usefulness of this novel approach for early diagnosis, treatment, and helping clinicians to optimize therapy by using this approach.
Journal of agricultural medicine and community health
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v.28
no.2
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pp.107-122
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2003
Objectives: The objective of this study is to investigate the use rate and some aspect of complementary therapies used by patients with chronic illness(hypertension, diabetic mellitus and chronic arthritis). Methods: 600 patients visiting the health center for one month(Jan. 2001) were interviewed on their complementary therapies used by the subjects for the previous year. Results: About fourteen-eight percent of the respondents used therapies; 35% of patients with hypertension, 44.6% of patients with diabetic mellitus and 62.9% of patients with chronic arthritis, which shows the highest rate among patients with three chronic disease. The use rate of complementary therapies indicates few meaningful differences according to the general characteristics of the interviewees. Hypertension patients used herb medication(31.0%) acupuncture(29.6%) and most of all the other therapies. Diabetic patients used dietary therapy(57.5%) and herb medication(35.1%). Chronic arthritis patients used acupuncture(85%) and herb medication(34.7%). 36.8% of all the patients who used complementary therapies tried more than two therapies. 18.3% of hypertension patients, 24.1% of diabetic patients and 55.9% of chronic arthritis patients used more than two therapies. Acupuncture(47%) was used most frequently, followed by herb medications(26.3%), health assistance utensils(21.8%). oriental therapy(21.8%), physical therapy(9.5%), health assistance food(8.4%), herb(7.7%), Korea hand acupuncture(3.2%), abdomen respiration(1.1%), and pore therapy(0.7%) Oriental clinic was visited most frequently(42.8%), which was used to cure diseases(61.8%), and to relieve symptoms(26.0%). (p<0.001) The cost spent on complementary therapies last year was 90,000 won(40.3%) and there are some cases of more than 500,000 won(31.2%). Most of the patients(56.1%) were satisfied with the complementary therapies, with 6% of them having side effects. 74% of the patients used complementary therapies answered that they would continue them and 56.1% of them also answered that they would continue them and 56.1% of them also answered that they would advise other patients to do them. Advantages(compared with those of orthodox medical treatment) are psychological comfort(28.1%), body protection(26.0%), effectiveness(20.0%). 34% of the patients using complementary therapies wanted to have informational orientation on complementary therapies. These findings reveal that a considerable number of patients with chronic illness(47.5%) tried a variety of complementary therapies. Though 6% of the patients using therapies had side effects, most of the subjects seemed satisfied with them and they are supposed to continue them. Conclusions: In conclusion, health center personnels and medical doctors should pay more attention to the complementary therapies used by patients with chronic illness. They also have to try their best to advise more scientific and informative complementary programs with less side effects and more help to improve their conditions.
The purpose of this study was to explore the effects of GEAP on pain, joint function, activities of daily living(ADL) and fatigue in chronic arthritis patients. The GEAP was held twice a week for 6 weeks for chronic arthritis patients at one university hospital in Seoul, Korea. Thirty four subjects completed the program, who were recruited at four times from September, 1999 to September, 2000. The effect of GEAP were evaluated as follows: Pain severity and number of painful joints ADL, fatigue were measured before and after the GEAP. In order to examine the joint flexibility and strengthening, the followings were measured: the extent of the upward arm reach in both sides(flexibility of shoulder), the ability to touch fingertips of the both hands in back pat and rub(flexibility of arm), the degree of range of motion (ROM) of both ankles in their dorsiflexion(flexibility of ankle) and plantarflexion with standing with toe(strengthening of ankle), and the degree of knee extension, and the grip strength. Paired t-test and Wilcoxon signed rank test were used for data analysis and the significance of the differences in the variables was examined to compare the data obtained before and after the GEAP. After the GEAP, followings were found: 1. Pain severity and number of painful joints was significantly decreased. 2. The flexibility of both shoulders and arms, knee, both ankle were significantly improved. 3. The strengthening of both arms was significantly improved, but the strengthening of ankle was not changed. 4. ADL was significantly increased. 5. Fatigue was significantly decreased. In conclusion, GEAP used in this study was clearly proved to be an effective exercise program to reduce pain and fatigue, to enhance joint function and ADL in people with chronic arthritis. It is suggested that the GEAP should be recommended as one of the useful and appropriate nursing interventions for chronic arthritis patients.
Journal of Korean Academy of Fundamentals of Nursing
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v.8
no.2
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pp.210-219
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2001
Purpose: To examine the effects of the GEAP on pain, fatigue, self-esteem, perceived health status and self-efficacy in patients with chronic arthritis. Methods: One group Pre- & post-test design was used. Outcome domains included pain, number of painful joints, fatigue, self-esteem, perceived health status and self-efficacy. Thirty-four patients were recruited over four times from a rheumatic clinic affiliated to a university medical center in Seoul, Korea The GEAP is an exercise program modified by the investigators from PACE program which developed by Arthritis Foundation. The program duration is about 60 minutes, three times a week for 6 weeks. Participants were predominantly women (68%) ; on average 57.3 years old; and diagnossed with RA (58.8), osteoarthritis (29.4) or other (11.8). Results: After completing the GEAP, subjects showed significant improvement in pain (p=.02), number of painful joints (P= .04), fatigue (p= .0001), and perceived health status (P=.006). There were no improvements in self-esteem and self-efficacy score for adults with chronic rheumatic diseases. Conclusion: This study showed that the GEAP is an effective exercise intervention for improving outcomes for patients with chronic arthritis. More sample and research are needed to 1) accurately evaluate on self-esteem and self-efficacy; 2) understand and improve adherence. And also a longer follow up period is recommended to evaluate long-term effects of the PACE program.
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